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Br J Sports Med 2004;38:248-249 doi:10.1136/bjsm.2003.011221
  • Inflammation
  • Leader

What is “inflammation”? Are we ready to move beyond Celsus?

  1. A Scott1,
  2. K M Khan1,
  3. J L Cook2,
  4. V Duronio1
  1. 1University of British Columbia, Vancouver, Canada
  2. 2La Trobe University, Victoria, Australia
  1. Correspondence to:
 Professor Khan
 Department of Family Practice, University of British Columbia, Suite 211, 2150 Western Parkway, Vancouver, British Columbia V6T 1V6, Canada; kkhaninterchange.ubc.ca

    Different definitions of inflammation are a cause for concern

    Inflammation, a term coined by the ancients, is widely used in sports medicine. But what is meant when a clinician tells a patient that symptoms are probably due to inflammation? The question of whether inflammation is helpful or harmful to healing can only be answered after inflammation is defined. This brief analysis of inflammation reveals that the term’s definition has changed dramatically since it was first used by Celsus nearly 2000 years ago. The definition also depends on the type of lens the viewer is using—whether it be clinical, cellular, or molecular.

    INFLAMMATION—WIDELY USED (AND ABUSED)

    On the one hand, the label inflammation is ascribed to a wide range of potential presentations in musculoskeletal medicine, but on the other, few clinicians would be able to define this complex biological cascade any better than Cornelius Celsus did in the 1st century ad. Nevertheless, this limited understanding of pathobiology does not limit therapeutic enthusiasm; American physicians prescribe drugs to block inflammation at a rate that costs patients over a billion US dollars annually. There has been an explosion of knowledge about inflammation over the second half of the 20th century, yet our clinical concepts about inflammation have remained relatively resistant to change. This leader highlights the evolution of the term inflammation as a prelude to …

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